Healthcare Provider Details

I. General information

NPI: 1952631012
Provider Name (Legal Business Name): HEALTH CENTERED SPINE & WELLNESS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/12/2010
Last Update Date: 08/01/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1725 E TIPTON ST STE. 200
SEYMOUR IN
47274-3561
US

IV. Provider business mailing address

1725 E TIPTON ST STE. 200
SEYMOUR IN
47274-3561
US

V. Phone/Fax

Practice location:
  • Phone: 812-519-2963
  • Fax: 812-519-3515
Mailing address:
  • Phone: 812-519-2963
  • Fax: 812-519-3515

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number8001579
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number01036180A
License Number StateIN
# 3
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number71001567A
License Number StateIN
# 4
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number71004638A
License Number StateIN

VIII. Authorized Official

Name: DR. JAMES C. GALYEN
Title or Position: OWNER/PARTNER
Credential: D.C.
Phone: 812-519-2963